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General NPI Number Information
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NPI Number | 1649119132
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Entity Type | Organization
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Legal Business Name | RED SHIELD MENTAL HEALTH COUNSELING PLLC
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 418 BROADWAY UNIT 7780
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City | ALBANY
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State | NY
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Zip | 12207
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Country | US
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Telephone | 347-674-0110
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Fax | 347-716-4220
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Provider Business Mailing Address
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Address Line | 2224 AVENUE U
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City | BROOKLYN
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State | NY
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Zip | 11229-3648
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Country | US
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Telephone | 347-674-0110
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Fax | 347-716-4220
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Authorized Official
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Title or Position | COO
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Name | SEMYON MAKAGON
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Credential |
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Telephone | 347-286-1779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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